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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2012

01-04-2012 | Breast Oncology

Favorable Outcome of Secondary Axillary Dissection in Breast Cancer Patients with Axillary Nodal Relapse

Authors: Shih-Che Shen, MD, Chien-Hung Liao, MD, Yung-Feng Lo, MD, Hsiu-Pei Tsai, MD, Wen-Lin Kuo, MD, Chi-Chang Yu, MD, Tzu-Chieh Chao, MD, Miin-Fu Chen, MD, Hsien-Kun Chang, MD, Yung-Chang Lin, MD, Wen-Chi Shen, MD, Shir-Hwa Ueng, MD, Li-Yu Lee, MD, Swei Hsueh, MD, Yi-Ting Huang, MD, Shin-Cheh Chen, MD

Published in: Annals of Surgical Oncology | Issue 4/2012

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Abstract

Purpose

Little evidence can be found about the long-term outcome of breast cancer patients after axillary lymph node recurrence (ALNR) and its survival benefit after different kinds of management. The present study intends to evaluate the risk factors associated with axillary recurrence after definite surgery for primary breast cancer. The prognosis after ALNR and particularly outcome of different management methods also were studied.

Methods

We retrospectively reviewed data from 4,473 patients who were diagnosed with primary breast cancer and received surgical intervention in a single institute from January 1990 to December 2002. Medical files were reviewed and data on survival were updated annually. Risk factors and prognosis of patients with axillary recurrence were analyzed. Breast–cancer-specific survival of patients with ALNR and outcomes after different management methods also were studied.

Results

After a median follow-up of 70.2 months, axillary recurrence developed in 0.8% of patients. Factors associated with ALNR included: age younger than 40 years, medial tumor location, no initial standard level I & II axillary dissection, and not receiving hormonal therapy. The 5-year breast–cancer-specific survival after ALNR was 57.9%. For patients who received further axillary dissection, the 5-year survival rate was 82.5% compared with 44.9% for patients who did not receive further dissection.

Conclusions

ALNR is a rare event in treating breast cancer. Young age at diagnosis and medially located tumor are associated with higher risk, but standardized initial axillary dissection to level II and adjuvant hormonal therapy is protective against ALNR. In patients with ALNR, the outcome is not dismal and survival may be improved if further axillary dissection is given.
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Metadata
Title
Favorable Outcome of Secondary Axillary Dissection in Breast Cancer Patients with Axillary Nodal Relapse
Authors
Shih-Che Shen, MD
Chien-Hung Liao, MD
Yung-Feng Lo, MD
Hsiu-Pei Tsai, MD
Wen-Lin Kuo, MD
Chi-Chang Yu, MD
Tzu-Chieh Chao, MD
Miin-Fu Chen, MD
Hsien-Kun Chang, MD
Yung-Chang Lin, MD
Wen-Chi Shen, MD
Shir-Hwa Ueng, MD
Li-Yu Lee, MD
Swei Hsueh, MD
Yi-Ting Huang, MD
Shin-Cheh Chen, MD
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-2082-8

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